2Aydın Adnan Menderes University Faculty of Medicine, Department of Anesthesiology and Reanimation, Aydın, Türkiye DOI : 10.29400/tjgeri.2025.466 Introduction: As the global population ages, the prevalence of agerelated decline and geriatric syndromes has increased. Postoperative cognitive dysfunction is a frequent but under-recognized complication in older patients. Frailty, characterized by reduced physiological reserve, may heighten vulnerability to cognitive decline after hospitalization and surgery. Although both conditions have been studied separately, their direct association remains unclear. This study investigated the relationship between frailty, geriatric syndromes, and postoperative cognitive dysfunction to improve understanding of perioperative cognitive vulnerability.
Materials and Method: A total of 305 patients aged ?65 years were classified into four groups: outpatients, patients without recent surgery, and surgical patients under spinal or general anesthesia. Frailty was assessed with the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight scale and the 11-item Modified Frailty Index. Cognitive function was evaluated with the Montreal Cognitive Assessment at baseline and on day three. A decline of more than one standard deviation was defined as postoperative cognitive dysfunction.
Results: Postoperative cognitive dysfunction occurred in 46% of patients. Univariate analysis showed associations with age, chronic disease, geriatric syndromes, American Society of Anesthesiologists physical status score, and frailty. Multivariate analysis identified age, American Society of Anesthesiologists score, and frailty as independent predictors. Patients aged ?85 years and those in American Society of Anesthesiologists class III had 11.6- and 3.2-fold higher risk, respectively. Frail and pre-frail individuals had 11.3- and 4.2-fold higher risk, respectively.
Conclusion: Advanced age, higher American Society of Anesthesiologists score, and frailty markedly increased the risk of postoperative cognitive dysfunction. Routine frailty screening may help identify vulnerable patients and guide preventive strategies
Keywords : Geriatrics; Frailty; Neuropsychological Tests; Cognitive Dysfunction